MEDICARE: MARIZZA JOY MARI PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	18916	MA

General Provider Information

NPI Number	:	1093119372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIZZA JOY MARI PT

Provider Business Mailing Address
First Line	:	1 FATHER DEVALLES BLVD
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02723-1511
Country	:	US
Telephone Number	:	508-673-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 FATHER DEVALLES BLVD
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02723-1511
Country	:	US
Telephone Number	:	508-673-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2014
Last Update Date	:	10/15/2014

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